Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1985 Jun 29;290(6486):1940–1943. doi: 10.1136/bmj.290.6486.1940

Screening for Down's syndrome using serum alpha fetoprotein: a retrospective study indicating caution.

K Spencer, P Carpenter
PMCID: PMC1416047  PMID: 2408699

Abstract

A report was made on the outcome of a four year retrospective study in 27 064 pregnancies, of the clinical efficiency, sensitivity, and specificity of a screening programme for Down's syndrome based on reported strategies related to the measurement of maternal serum alpha fetoprotein. This study identified 27 pregnancies affected by Down's syndrome with a median multiple of the median maternal serum alpha fetoprotein concentration of 0.82. This figure is considerably higher than that obtained from previous reports on this subject. With an age related multiple of the median maternal serum alpha fetoprotein strategy, 30.8% of Down's affected pregnancies were identified as well as 11.6% of unaffected pregnancies. Perhaps a United Kingdom collaborative study should begin to investigate the reasons for such wide population variance in the reports for the median multiple of the median for Down's affected pregnancies. Until such studies are carried out, screening for Down's syndrome based on low maternal serum alpha fetoprotein concentration is premature.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brambati B., Simoni G. Diagnosis of fetal trisomy 21 in first trimester. Lancet. 1983 Mar 12;1(8324):586–586. [PubMed] [Google Scholar]
  2. Brock D. J. Maternal serum alpha-fetoprotein as screening test for Down syndrome. Lancet. 1984 Jun 9;1(8389):1292–1292. doi: 10.1016/s0140-6736(84)92463-2. [DOI] [PubMed] [Google Scholar]
  3. Cuckle H. S., Wald N. J., Lindenbaum R. H. Maternal serum alpha-fetoprotein measurement: a screening test for Down syndrome. Lancet. 1984 Apr 28;1(8383):926–929. doi: 10.1016/s0140-6736(84)92389-4. [DOI] [PubMed] [Google Scholar]
  4. Haddow J. E., Kloza E. M., Knight G. J., Smith D. E. Relation between maternal weight and serum alpha-fetoprotein concentration during the second trimester. Clin Chem. 1981 Jan;27(1):133–134. [PubMed] [Google Scholar]
  5. Houlsby W. T. Maternal serum AFP as screening test for Down's syndrome. Lancet. 1984 May 19;1(8386):1127–1127. doi: 10.1016/s0140-6736(84)92545-5. [DOI] [PubMed] [Google Scholar]
  6. Loeffler F. E. Prenatal diagnosis. Chorionic villus biopsy. Br J Hosp Med. 1984 Jun;31(6):418–420. [PubMed] [Google Scholar]
  7. Low maternal serum AFP and Down syndrome. Lancet. 1984 Jul 21;2(8395):161–162. [PubMed] [Google Scholar]
  8. McNay M. B., Whitfield C. R. Prenatal diagnosis. Amniocentesis. Br J Hosp Med. 1984 Jun;31(6):406-7, 410-11, 13 passim. [PubMed] [Google Scholar]
  9. Merkatz I. R., Nitowsky H. M., Macri J. N., Johnson W. E. An association between low maternal serum alpha-fetoprotein and fetal chromosomal abnormalities. Am J Obstet Gynecol. 1984 Apr 1;148(7):886–894. doi: 10.1016/0002-9378(84)90530-1. [DOI] [PubMed] [Google Scholar]
  10. Prenatal screening for Down syndrome. Lancet. 1984 Jun 16;1(8390):1359–1360. [PubMed] [Google Scholar]
  11. Rodeck C. H., Morsman J. M. First-trimester chorion biopsy. Br Med Bull. 1983 Oct;39(4):338–342. doi: 10.1093/oxfordjournals.bmb.a071845. [DOI] [PubMed] [Google Scholar]
  12. Wald N., Cuckle H., Boreham J., Terzian E., Redman C. The effect of maternal weight on maternal serum alpha-fetoprotein levels. Br J Obstet Gynaecol. 1981 Nov;88(11):1094–1096. doi: 10.1111/j.1471-0528.1981.tb01759.x. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES